Autism

Ryan’s Story

Ryan is a healthy, active two- year-old, but his parents are concerned because he doesn’t seem to be
doing the same things that his older sister did at this age. He’s not really talking yet, although
sometimes he repeats, over and over, words that he hears others say. He doesn’t use words to
communi- cate, though. It seems he just enjoys the sounds of them. Ryan spends a lot of time
playing by himself. He has a few favorite toys, mostly cars, or anything with wheels on it! And
sometimes, he spins himself around as fast as he does the wheels on his cars. Ryan’s parents are
really concerned, as he’s started throwing a tantrum whenever his routine has the smallest change.
More and more, his parents feel stressed, not knowing what might trigger Ryan’s next upset.

Often, it seems Ryan doesn’t notice or care if his family or anyone else is around. His parents just
don’t know how to reach their little boy, who seems so rigid and far too set in his ways for his tender
young age. After talking with their family doctor, Ryan’s parents call the Early Intervention office in
their community and make an appointment to have Ryan evaluated.

When the time comes, Ryan is seen by several professionals who play with him, watch him, and ask
his parents a lot of questions. When they’re all done, Ryan is diagnosed with autism, one of the five
disorders listed under an umbrella cat- egory of “Pervasive Develop-

mental Disorders”—a category that’s often referred to as simply the “autism spectrum.”

As painful as this is for his parents to learn, the early intervention staff encourage them to learn
more about the autism spectrum. By getting an early diagnosis and beginning treatment, Ryan has
the best chance to grow and develop. Of course, there’s a long road ahead, but his parents take
comfort in knowing that they aren’t alone and they’re getting Ryan the help he need.

What are the Characteristics of Autism Spectrum Disorders

Each of the disorders on the autism spectrum is a neurologi- cal disorder that affects a child’s ability
to communicate, under- stand language, play, and relate to others. They share some or all of the
following characteris- tics, which can vary from mild to severe:

• Communication problems (for example with the use or comprehension of language)

Difficulty relating to people, things, and events;

• Playing with toys and objects in unusual ways;

• Difficulty adjusting to changes in routine or to familiar surroundings; and

• Repetititive body move- ments or behaviors.1

These characteristics are typically evident before the age of three.

Children with autism or one of the other disorders on the autism spectrum can differ considerably
with respect to their abilities, intelligence, and behaviour. Some children don’t talk at all. Others use
language where phrases or conversations are repeated. Children with the most advanced language
skills tend to talk about a limited range of topics and to have a hard time understanding abstract
concepts. Repetitive play and limited social skills are also evident. Other common symptoms of a
disorder on the autism spectrum can include unusual and sometimes uncon- trolled reactions to
sensory information—for instance, to loud noises, bright lights, and certain textures of food or
fabrics.

What are the Specific Disorders on the Autism Spectrum?

There are five disorders classified under the umbrella category officially known as Pervasive
Developmental Disorders, or PDD. As shown above, these are:

• autism;

• Asperger syndrome;

• Rett syndrome;

• childhood disintegrative disorder; and

• Pervasive Developmental Disorder Not Otherwise Specified (often referred to as PDDNOS).2

Although there are subtle differences and degrees of severity between these five conditions, the
treatment and educational needs of a child with any of these disorders will be very similar. For that
reason, the term “autism spectrum disorders”—or ASDs, as they are sometimes called— is used
quite often now and is actually expected to become the official term to be used in the future (see
the box on the next page).3

The five conditions are defined in the Diagnostic and Statistical Manual, Fourth Edition, Text Revision
(DSM-IV-TR) of the American Psychiatric Society (2000). This is also the manual used to diagnose
autism and its associated disorders, as well as a wide variety of other disabili- ties.

At the moment, according to the 2000 edition of the DSM- IV, a diagnosis of autistic disor- der (or
“classic” autism) is made when a child displays 6 or more of 12 symptoms across three major areas:

• social interaction (such as the inability to establish or maintain relationships with peers
appropriate to the level of the child’s develop- ment,

• communication (such as the absence of language or delays in its development), and

• behavior (such as repetitive preoccupation with one or more areas of interest in a way that is
abnormal in its intensity or focus).

When children display similar behaviors but do not meet the specific criteria for autistic disorder,
they may be diagnosed as having one of the other disorders on the spec- trum—Aspergers, Rett’s,
child- hood disintegrative disorder, or PDDNOS. PDDNOS (Pervasive Developmental Disorder Not
Otherwise Specified) is the least specific diagnosis and typically means that a child has dis- played
the least specific of autistic-like symptoms or behaviors and has not met the criteria for any of the
other disorders.
Terminology used with autism spectrum disorders can be a bit confusing, especially the use of PDD
and PDDNOS to refer to two different things that are similar and intertwined. Still, it’s important to
remember that, regardless of the specific diagnosis, treatments will be similar.

How common are ASDs

According to the National Institute of Mental Health (NIMH) and the Centers for Disease Control and
Prevention (CDC), some form of autism affects 2 - 6 of every 1,000 children, with the most recent
statistic being 1 in 110.4 ASDs are four times more common in boys than in girls, although Rett
Syndrome has only been diagnosed in girls.5

What Causes an ASD?

The causes of autism and the other disorders on the spectrum are not known. Researchers are
currently study- ing such areas as neurological damage and chemical imbalances within the brain.
These disorders are not due, however, to psychological factors or, as has been widely reported in
the press, to childhood vaccines.

Is there Help Available?

Yes, there’s a lot of help available, beginning with the free evaluation of the child. The nation’s
special education law, the Individuals with Dis- abilities Education Act (IDEA), requires that all
children suspected of having a disability be evaluated without cost to their parents to determine if
they do have a disability and, because of the disability, need special services under IDEA. Those
special services are:

• Early intervention | A system of services to support infants and toddlers with disabilities (before
their 3rd birthday) and their families.

• Special education and related services | Services available through the public school system for
school-aged children, including preschoolers (ages 3-21).